Submitting Business to MedAmerica Mutual

The following materials provided electronically or in hard copy comprise a submission:

• Completed, signed and dated application for the group.
• An Executive Summary identifying the group's history, their mission statement, their risk management philosophies, and any other extraordinary defining characteristics.
• Carrier generated, currently valued loss runs for the past 10 years.
• "Emergency Medicine Services" contract with each hospital or facility.
• Name and address of each facility with which the group contracts.
• Current declarations page and physician roster evidencing limits of insurance and retroactive dates.
• Policy form being used by the current carrier with explanation of the claims trigger in the policy.
• Letterhead, brochures and other printed material used by the group.
• Most recent audited financial statements.

If multiple submissions are received on a single emergency physician medical group, the broker providing a complete submission will be the controlling broker unless a subsequent broker submits a "Broker of Record Letter" from the client. If a proposal is offered, it will provide information on the pricing, coverage, forms, subjectivities, and conditions required to bind coverage. Risk analysis is an integral component of our underwriting and risk selection. On larger, complex accounts, a risk manager may perform an on-site review of the account or conduct a telephone interview. Our broker partners will be asked to participate in these activities.